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A big role for the very small—understanding the endodontic microbial flora
Author(s) -
Figdor D.,
Sundqvist G.
Publication year - 2007
Publication title -
australian dental journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.701
H-Index - 71
eISSN - 1834-7819
pISSN - 0045-0421
DOI - 10.1111/j.1834-7819.2007.tb00524.x
Subject(s) - obligate anaerobe , flora (microbiology) , root canal , obligate , biology , periodontitis , enterococcus faecalis , facultative , oral microbiology , microbiology and biotechnology , gram positive cocci , dentistry , ecology , bacteria , anaerobic exercise , medicine , staphylococcus aureus , physiology , genetics
Apical periodontitis, an inflammatory process around the apex of a tooth root, is primarily a sequel to microbial infection of the pulp space. The microbial flora is composed of a restricted group of the total oral flora, selected by environmental pressures of anaerobiosis, nutrition and competition with other species and inhabits the root canal as a biofilm of coaggregated communities in an extracellular matrix. The untreated infected canal is generally composed of a polymicrobial mix with approximately equal proportions of Gram‐positive and Gram‐negative species, dominated by obligate anaerobes. The type of microbial flora in the root‐filled tooth with persistent apical periodontitis has very different characteristics. These infections are characterized by one or just a few species, predominantly Gram‐positive micro‐organisms with an equal distribution of facultative and obligate anaerobes. Enterococcus faecalis has been a conspicuous finding in most studies. Because the primary aetiological problem is infection, endodontic treatment is directed at control and elimination of the root canal flora by working in a sterile way. Based on current knowledge, the best available method for obtaining clean, microbe‐free root canals is by instrumentation with antimicrobial irrigation reinforced by an intracanal dressing with calcium hydroxide.